Sport and nutrition in lipoedema therapy
Lipoedema patients often suffer for many years, physically as well as mentally, before the correct diagnosis allows a better understanding of their disease. Often their complaints are not taken seriously and they are wrongly labelled as “fat”. As pure lipoedema and the resulting accumulation of fat tissue cannot, however, be remedied through dieting, frustration is pre-programmed.
Nevertheless, those affected are recommended to be aware of their normal weight. For already being slightly overweight can reinforce the development of edema and worsen the condition. However, more than half of those affected suffer from a mixture consisting of lipoedema with accompanying obesity (adiposity). In this case losing weight has top priority. However, we are here not talking about a traditional diet. In fact, therapy consists of a controlled combination of three components:
- Dietary change
- Pysical activity
- Psychological care and support (especially in the case of an eating disorder)
The above therapy should allow a person to keep their normal weight in the long term.
As a high insulin level has a negative effect on the development of edema, “isoglycemic nutrition” is recommended. At the same time sufficient breaks between meals should be adhered to and blood sugar and insulin peaks avoided. Moreover, protein intake must be adjusted to the requirements of muscle mass, for weight reduction should not occur at the expense of muscle mass (ketogenic nutrition). Experienced dietitians or special nutritional therapy can play a sensible role in the case of dietary change.
Sport and movement with lipoedema
The higher the weight of those affected, the more difficult they find movement or let alone sports activities to be. In addition, joints are due to the heavy weight subject to great stress with certain types of sport. That is why water sports from classic swimming to aquarobics (aerobics in water) to Aqua Cycling (cycling in water) have proven to be helpful. In water the joints are subject to less stress and water pressure has a positive effect on the edema.
Psychotherapy / psychological care and support
The unusual body proportions of lipoedema patients and the severe pain often also cause much psychological suffering. Due to their appearance patients are often subjected to disdainful glances or are bullied. As a result, they occasionally shun people to avoid hostility. The feeling of being different creates low self-esteem and may even lead to major depression. Also the partner feels unsure, as any form of touching hurts.
For many of those affected it is generally difficult to find a suitable partner, which may then also lead to an inferiority complex. Moreover, many succumb to an eating disorder, ranging from starving themselves and doing excessive exercises to comfort eating.
Further components of lipoedema treatment
In order to reduce the edema as well as the pain, complex decongestive physiotherapy (CDP) is used. It consists of five therapeutic building blocks:
- Manual lymphatic drainage
- Compression therapy with bandages and compression stockings
- Skin care
- Physical exercises
- Self-management and clarification
If despite the fact that decongestive therapy has been carried out on a consistent basis symptoms still exist, liposuction may be considered. To date liposuction is the only treatment that can remove the diseased fat tissue permanently. However, the intervention is a grave decision and should not be taken lightly. At all times, an experienced physician should be consulted to avoid lymph channels being damaged during the liposuction process, thus resulting in lipo-lymphoedema. Furthermore, liposuction is expensive and is only seldom paid for by sickness funds. Physicians also recommend removing the diseased fat tissue only when weight is at a normal level (BMI: 18.5 – 24.9).